Evaluation of a group format of clinician-guided, parent-delivered cognitive behavioural therapy for child anxiety in routine clinical practice: a pilot-implementation study.
Evans R., Hill C., O'Brien D., Creswell C.
BACKGROUND: Randomised controlled trials suggest that cognitive behavioural therapy (CBT) delivered by parents who are guided, in groups, by clinicians (Group GPD-CBT) is an efficacious and potentially efficient treatment approach for child anxiety. The extent to which these results translate to routine settings is unclear. We evaluated Group GPD-CBT as delivered in UK routine clinical services. METHOD: Retrospective data regarding attendance and outcomes were routinely collected for 83 children whose parent(s) had attended Group GPD-CBT. Semistructured interviews were conducted with 14 clinicians who had delivered Group GPD-CBT. RESULTS: By 3-8 months (M = 5.22, SD = 1.17) post-treatment, 70% of children were discharged or referred for support for other (non-anxiety) conditions, without any further intervention for anxiety. Of the subset (N = 20) with available parent-report symptom data, there was a significant decline in total anxiety score from pre- to post-treatment. Clinician interviews were analysed using thematic analysis. This revealed that clinicians found Group GPD-CBT to be acceptable and described it as a helpful, practical and empowering treatment for child anxiety. They highlighted additional benefits associated with group process factors (e.g. peer support, enhanced engagement), although noted that some, particularly anxious, parents were reluctant to attend a group format. CONCLUSIONS: Results were promising regarding children's outcomes following Group GPD-CBT delivered in routine practice. Group GPD-CBT was viewed by clinicians as acceptable and helpful, and group process factors were seen to provide additional benefits. Some parents may find it difficult to attend a group format, suggesting that services should give careful consideration to how groups are presented and introduced to parents.